<@master template="/common/master"  title="申请资料">
<@css href="/css/wx/recruit/dk.css" rel="stylesheet"/>
	<div class="header">
	    	<a href="/eascs-o2o-h5/reloan/index"><i class="backIco"></i></a>申请信息
    </div>
    <div id="formDiv">
    	<ul class="dkUl">
        	<li>
            	<input name="uname" type="text" placeholder="请填写姓名" class="dkInput">
            	姓名 
            </li>
            <li>
            	<input name="IdCard" id="IdCard" type="text" placeholder="请填写身份证号码" class="dkInput">
            	身份证号 
            </li>
            <li>
            	<input name="tel"  type="tel" placeholder="请填写手机号码" class="dkInput">
            	手机号码
            </li>
        </ul>
        <ul class="dkUl ct">
        	<li id="city">
		        <span>门店地址</span>
		        <div class="fr" id="city">
		         	<select name="province" class="prov"><option value="">请选择</option></select>&nbsp;
		            <select name="city" class="city"><option value="">请选择</option></select>
		        </div>
     		 </li> 
		      <li>
		        <span>注册时间</span>
		        <input id="meeting"  name="registerTime" type="date" class="fr mt15">
		      </li> 
        </ul>
        <ul class="dkUl mt20">
		    <li>
		        <span>续贷金额</span>
		        <select name="loanMoney" id="loanMoney" class="dkSel">
                    <option value="">请选择</option>
                    <option value="5">5万</option>
	                <option value="10">10万</option>
	                <option value="15">15万</option>
	                <option value="20">20万</option>
	                <option value="25">25万</option>
	                <option value="30">30万</option>
	                <option value="35">35万</option>
	                <option value="40">40万</option>
	                <option value="45">45万</option>
	                <option value="50">50万</option>
		        </select>
		    </li>
		    <li>
		        <span>续贷期限</span>
		        <select name="loanTime" id="loanTime" class="dkSel">
                      <option value="">请选择</option>
	                  <option value="6">6个月</option>
	                  <option value="12">12个月</option>
		        </select>
		    </li>           
		</ul>
        <a id="submitBtn" href="javascript:void(0)" class="dkbtn">立即申请</a>
    </div>
<div id="showMsgDiv" class="tcTxt1 smDiv" style="display:none;">
    <div class="tcjz"></div>
</div>
</@master>
<script>
	 document.getElementById("showMsgDiv").style.height = document.body.clientHeight + 'px'; 
</script>
<script>
var _hmt = _hmt || [];
(function() {
  var hm = document.createElement("script");
  hm.src = "https://hm.baidu.com/hm.js?3ab2a83a372d20f084552b836c038302";
  var s = document.getElementsByTagName("script")[0]; 
  s.parentNode.insertBefore(hm, s);
})();
</script>
<@js src="/widget/cityselect/city.min.js"/><@jsRender/>
<@js src="/js/wx/recruit/cityselect.js"/><@jsRender/>
<@js src="/js/wx/reloan/reLoan.js"/><@jsRender/>